CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(04): 532-540
DOI: 10.1055/s-0043-1768641
Pictorial Review

Bright Is Not Always Better: A Pictorial Review of Hyperechoic Malignant Breast Masses

Shivya Parashar
1   Department of Radiodiagnosis, Medanta the Medicity, Gurugram, Haryana, India
Jyoti Arora
1   Department of Radiodiagnosis, Medanta the Medicity, Gurugram, Haryana, India
Ayushi Mittal
1   Department of Radiodiagnosis, Medanta the Medicity, Gurugram, Haryana, India
› Author Affiliations


Hyperechogenic breast lesions are a relatively rare finding at breast ultrasonography and are traditionally thought to be benign. However, hyperechogenicity on the ultrasound alone does not provide enough evidence to rule out malignancy completely. We herein reported a short series of nine cases of echogenic malignant breast lesions, which include invasive ductal carcinoma, ductal carcinoma in situ, invasive lobular carcinoma, angiosarcoma, lymphoma, and metastasis to the breast. Echogenic breast lesions should be carefully evaluated and properly categorized based on any other suspicious sonographic characteristics and must be correlated with mammographic findings and clinical history to lower the threshold for biopsy and avoid delay in diagnosis.

Hyperechogenicity should not be considered as a characteristically benign feature and should not supersede the less specifically benign features of the same lesion on the other examination.

Author Contributions

S.P. diagnosed cases, collected all images, searched literature, and prepared the manuscript. J.A. diagnosed cases, confirmed diagnosis, searched literature, and reviewed the manuscript. A.M. collected all images and searched literature.

Publication History

Article published online:
06 May 2023

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